If you're looking for a comprehensive Medicare Advantage HMO plan with prescription drug benefits, we are pleased to offer Moda Health HMO. This plan was designed with both your medical and prescription drug needs in mind, offering excellent benefits that fit your lifestyle. With the Moda Health HMO plan, you will enjoy the following benefits:

Low deductible of $85

Worldwide coverage for emergency services

Routine eye exam once every year

Protection of an annual out-of-pocket maximum

Coordination of care services

Part D prescription drug coverage

Medical coverage

Moda Health HMO

In-network

Monthly health plan premium

$91

Annual out-of-pocket maximum

$3,400

Annual medical deductible

$85

Primary care provider

$25 copay

Specialist office visit (4)

$35 copay

Inpatient hospital care (per stay) (1) (3)

$300 per day for days 1 - 5

Outpatient surgery (per stay) (3)

20% hospital
or 10% ASC (2)

Medicare-covered preventive services

$0 copay

Lab services

$0 copay

X-ray, CT, MRI, PET, etc. (3)

20% coinsurance

Routine vision exam once every year

$35 copay

Moda Health Extra Care is available at an additional $12 premium per month and includes non-Medicare covered services such as chiropractic, naturopathic, acupuncture, hearing services and vision hardware. 50% coinsurance for services up to a combined $500 maximum benefit per year.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or copayments/coinsurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium.

Non-contracted providers are under no obligation to treat Moda Health Plan, Inc. members, except in emergency situations. For a decision about whether we will cover a service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our Member Services number or see your Evidence of Coverage for more information, including the cost-sharing that applies to your services.

We have free interpreter services to answer any questions you may have about our health or drug plan. To get an interpreter, just call us at 1-877-299-9062. This is a free service. To see this message in another language refer to Multi-language Interpreter Services notice.

Last updated October 1, 2017
Y0115_WEB_2018A Approved

We're sorry, we don't currently offer Medicare plans in . View our plans in or use the dropdown at the top of the page to view Medicare plans in Oregon.

If you're looking for a comprehensive Medicare Advantage HMO (HMO-POS) plan with prescription drug benefits, we are pleased to offer Moda Health HMO (HMO-POS). This plan was designed with both your medical and prescription drug needs in mind, offering excellent benefits that fit your lifestyle. With the Moda Health HMO (HMO-POS) plan, you will enjoy the following benefits:

Moda Health Extra Care is available at an additional $12 premium per month and includes non-Medicare covered services such as chiropractic, naturopathic, acupuncture, hearing services and vision hardware. 50% coinsurance for services up to $500 maximum benefit per year.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or
copayments/coinsurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium.

Out-of-network/non-contracted providers are under no obligation to treat Moda Health Plan, Inc. members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our Member Services number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

We have free interpreter services to answer any questions you may have about our health or drug plan. To get an interpreter, just call us at 1-877-299-9062. This is a free service. To see this message in another language refer to Multi-language Interpreter Services notice

Last updated October 1, 2016
YY0115_WEB_2017A Approved

We're sorry, we don't currently offer Medicare plans in . View our plans in or use the dropdown at the top of the page to view Medicare plans in Oregon.

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